Life Without Grady

Tom Crawford

They have been writing Grady Memorial Hospital’s obituary for several years now, but this time it looks as if the venerable Atlanta institution could really be headed for the morgue.

Grady has been hounded by financial problems for a long time, but the latest prognosis is especially disheartening: An estimated $74 million deficit by year’s end will make it impossible for the hospital to meet its payroll. At that point, there’s little to do but shut the doors and send patients elsewhere.

The average Georgian living outside the metro area might shrug his or her shoulders over this prediction and dismiss the whole crisis as an “Atlanta problem.”

That would be a terribly shortsighted viewpoint. If Grady were ever forced to close down, the state would have a healthcare disaster on its hands that would affect people living far beyond Interstate 285.

If you’re injured in a serious auto accident, for example, and you need the specialized emergency care that is available at a trauma center, Grady is the only such facility north of Interstate 20. Without Grady, you would have to be evacuated to Savannah for that level of trauma care.

If you live anywhere in the Southeastern United States and are badly burned in a fire, you’ll probably be sent to Grady’s burn center, the most sophisticated such facility in the region. Without Grady, many people would die or suffer excruciating pain from third-degree burns.

If you ever see a doctor – no matter where you live in Georgia – then there’s a good possibility your physician received his or her early training at Grady, the state’s largest teaching hospital. Without Grady, where will our doctors learn the nuts and bolts of healing?

Grady is in dire financial straits partly because it treats large numbers of people referred there by other hospitals because they have no health insurance or financial means to pay their medical bills. Without Grady, these indigent patients will go to other facilities that will be forced to treat them and absorb the costs – putting hospitals across the state in deeper financial jeopardy.

If you take the rock that is Grady Memorial Hospital and let it sink into the state’s healthcare pool, the ripples will be felt in all corners of Georgia.

Fortunately, there seems to be an understanding among some of the leadership at the capitol that Grady’s situation will have to be addressed. House Speaker Glenn Richardson appointed a special legislative committee earlier this summer to develop proposals for keeping Grady from going bankrupt. Lt. Gov. Casey Cagle has also been quick to recognize that the hospital must be kept financially viable.

“If Grady’s not there,” Richardson says, “the surrounding hospitals are going to have to pick up the pieces.”

There’s already one interesting proposal on the table from a task force of business leaders assembled by the Metro Atlanta Chamber of Commerce. They recommend that Grady’s current governing board relinquish control of the hospital’s daily operations to a nonprofit corporation. By taking this step, the hospital would have access to additional financial resources and the General Assembly would be more amenable to the idea of providing state assistance.

Resistance to this proposal, or others that might be put forward, can already be seen among political figures in Fulton and DeKalb counties who appoint the members of Grady’s hospital authority and don’t want to give up that symbol of control.

There may have been a time when we had the luxury of stroking the political egos and working out a grand compromise to resolve Grady’s financial crisis and keep everybody happy. But time has run out.

If political leaders in Fulton and DeKalb will not make the governance changes that Grady needs, then the General Assembly should simply take the hospital out of their hands and put it under the operational control of a state authority. (While they’re at it, they could also take a look at setting up state or regional authorities to run MARTA and Hartsfield-Jackson Airport, but that’s another topic for another day.)

Without Grady Memorial Hospital, Georgia’s healthcare system would be in deep trouble. Let’s stop wasting time on this and get the ball rolling.